Retrograde intra-renal surgery (RIRS) has become increasingly common and is mainly performed under general anesthesia (GA). There are no specific papers about RIRS performed under spinal anesthesia (SA). Our objective was to evaluate feasibility and results of RIRS performed under SA. METHODS: We analyzed all consecutive RIRS performed for stones in day surgery from March 2008 to September 2012. Single procedures outcomes of RIRS performed under SA were evaluated with US and KUB X-ray at 2 weeks. Further treatments, operative time and complications were also evaluated. Outcomes of RIRS performed under SA and GA were compared. Difference between groups was statistically analyzed. Significance level was set at P<0.05. RESULTS: One hundred thirty-nine RIRS under SA and 47 under GA were considered. Mean stone burden was 14±6 mm. No case of conversion from SA to GA occurred. Stone-free rate (SFR) level 4U of RIRS under SA and under GA were respectively 63.6% and 48.6%, SFR level 0U 24.5% and 25.7%, CIRF 39.1% and 22.9%. Further treatments were performed respectively in 20.8% and in 23.4%. No anesthesia-related and Clavien-Dindo grade ≥3 complications occurred. No statistically significant difference was found in stone-free rates, CIRF and significant residual fragments rates, need for further procedures, operative time and complications between the two groups. CONCLUSIONS: RIRS under SA seems feasible and effective for renal stones in day surgery. Results seem equivalent to RIRS under GA. SA can be considered for RIRS as an alternative to GA.

Retrograde intra-renal surgery under spinal anesthesia: The first large series

Dalmasso, Ettore;ALESSANDRIA, EUGENIO;AGOSTI, SIMONE CARLO;PIZZUTO, GIUSEPPE;PERETTI, DARIO;Palazzetti, Anna;BISCONTI, Alessandro;Fop, Fabrizio;Gontero, Paolo
2018

Abstract

Retrograde intra-renal surgery (RIRS) has become increasingly common and is mainly performed under general anesthesia (GA). There are no specific papers about RIRS performed under spinal anesthesia (SA). Our objective was to evaluate feasibility and results of RIRS performed under SA. METHODS: We analyzed all consecutive RIRS performed for stones in day surgery from March 2008 to September 2012. Single procedures outcomes of RIRS performed under SA were evaluated with US and KUB X-ray at 2 weeks. Further treatments, operative time and complications were also evaluated. Outcomes of RIRS performed under SA and GA were compared. Difference between groups was statistically analyzed. Significance level was set at P<0.05. RESULTS: One hundred thirty-nine RIRS under SA and 47 under GA were considered. Mean stone burden was 14±6 mm. No case of conversion from SA to GA occurred. Stone-free rate (SFR) level 4U of RIRS under SA and under GA were respectively 63.6% and 48.6%, SFR level 0U 24.5% and 25.7%, CIRF 39.1% and 22.9%. Further treatments were performed respectively in 20.8% and in 23.4%. No anesthesia-related and Clavien-Dindo grade ≥3 complications occurred. No statistically significant difference was found in stone-free rates, CIRF and significant residual fragments rates, need for further procedures, operative time and complications between the two groups. CONCLUSIONS: RIRS under SA seems feasible and effective for renal stones in day surgery. Results seem equivalent to RIRS under GA. SA can be considered for RIRS as an alternative to GA.
MINERVA UROLOGICA E NEFROLOGICA
70
3
333
339
https://www.minervamedica.it/en/getpdf/mF05Opy22LPD5F6cB1DmrGVcB3hzMSVjzWO52FpIHaUe4zdPLHCxW8ynOf5o%252BKClv7TQo3%252F6r2i0aKrT2RyPSw%253D%253D/R19Y2018N03A0333.pdf
Ambulatory surgical procedures; Anesthesia; Kidney calculi; Spinal; Ureteroscopy; Urolithiasis; Nephrology; Urology
Bosio, Andrea*; Dalmasso, Ettore; Alessandria, Eugenio; Agosti, Simone; Pizzuto, Giuseppe; Peretti, Dario; Palazzetti, Anna; Bisconti, Alessandro; Destefanis, Paolo; Fop, Fabrizio; Gontero, Paolo
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2318/1680432
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